• Title/Summary/Keyword: 우회전

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Risk Factors of Morbidity and Mortality after Coronary Artery Bypass Grafting (관상동맥우회로 이식술 후 이환과 사망의 위험요인)

  • 박창률;이응배;전상훈;장봉현;이종태;김규태
    • Journal of Chest Surgery
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    • v.31 no.12
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    • pp.1159-1164
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    • 1998
  • Background: Although operative outcome is progressing due to the development of operative techniques and myocardial protection, some patients face an increased morbidity and mortality. Therefore, it has become increasingly important to predict the operative morbidity and mortality. Material and Method: This retrospective study reports the results of risk factor analysis of morbidity and mortality of 137 consecutive patients who were underwent coronary artery bypass graft surgery(CABG). Preoperative variables were age, sex, preoperative myocardial infarction, operative priority, left ventricular ejection fraction, obesity and triple vessel disease. Postoperative morbidities were arrhythmia, wound infection, cerebral infarction, prolonged postoperative hospitalization, pneumonia, acute renal failure, prolonged use of ventilator and operative death. Result: The mean age of total patients was 56.7 years, from 27 to 74. The overall mortality was 6.6%(9 of 137) with the mortality of 3.9%(5 of 128) for elective operation, and 44.4%(4 of 9) for emergent or urgent cases. The morbidity of patients over 65 years was stastistically higher than that of under 65 years. Sex distribution showed no difference in morbidity, however operative mortality rate was slightly higher in women (5/41, 12.19%) than in men(4/96, 4.17%). Morbidity of emergent or urgent operation was 100%, much higher than that of the elective operation. Mortality of the patients whose left ventricular ejection fraction was under 50% was higher than that of those over 50%. Conclusion: We concluded that the risk factors of morbidity after CABG were old age above 65 years and emergent or urgent operation, and that risk factors of mortality were low left venticular ejection fraction under 50% and emergent or urgent operation.

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The Immediate and Long Term Result of Surgical Angioplasty of Left Main and Proximal Left Anterior Decending Coronary Artery (좌주관상동맥 및 좌전하행지기시부의 수술적 혈관 성형술의 중장기 성적)

  • 안현성;김응중;신윤철;지현근;이원용
    • Journal of Chest Surgery
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    • v.34 no.9
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    • pp.692-697
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    • 2001
  • Background: The left main coronary artery surgical angioplasty has become the choice of surgical procedure in isolated LM disease. We have performed 22 cases of LMCA surgical angioplasy since 1996. We report the immediate and long term result of the surgical angioplasty with their postoperative angiography. Material and Method: Between July 1994 and October 2000, 22 patients(11 men and 11 women) were subjected to surgical patch angioplasty of the LMCA, 1 patient had an additional angioplasty performed on the proximal right coronary artery. The LMCA was approached anteriorly with or without transection of the main pulmonary artery(21 cases), and in a patient who had undergone an aortic valve replacement, LMCA was approached superiorly with transection of the ascending aorta. Additional grafting was required in 5 cases. The on-lay patch was used with autologous pericardium in 6 cases and bovine pericardium in 16 cases. Result: There was no operative mortality. There was 30~50% stenosis of the anastomosis site in 3 cases at the postop. coronary angiography. Coronary angiography was reperformed in 5 cases between 5th months and 15th months postoperatively. There was 40~60% stenosis of the anastomosis site in 2 cases. There was one death at 42nd months postoperatively but the cause was unknown. No patient complained of angina with a mean follow up of 48.$\pm$22.5 months. Conclusion: There were only several coronary angiographic results in long term follow-up but we had relatively good clinical results for LMCA surgical angioplasty in the immediate and long term. The excellence of LMCA surgical angioplasty needs the result of the long term follow-up.

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Recognition Method of Korean Abnormal Language for Spam Mail Filtering (스팸메일 필터링을 위한 한글 변칙어 인식 방법)

  • Ahn, Hee-Kook;Han, Uk-Pyo;Shin, Seung-Ho;Yang, Dong-Il;Roh, Hee-Young
    • Journal of Advanced Navigation Technology
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    • v.15 no.2
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    • pp.287-297
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    • 2011
  • As electronic mails are being widely used for facility and speedness of information communication, as the amount of spam mails which have malice and advertisement increase and cause lots of social and economic problem. A number of approaches have been proposed to alleviate the impact of spam. These approaches can be categorized into pre-acceptance and post-acceptance methods. Post-acceptance methods include bayesian filters, collaborative filtering and e-mail prioritization which are based on words or sentances. But, spammers are changing those characteristics and sending to avoid filtering system. In the case of Korean, the abnormal usages can be much more than other languages because syllable is composed of chosung, jungsung, and jongsung. Existing formal expressions and learning algorithms have the limits to meet with those changes promptly and efficiently. So, we present an methods for recognizing Korean abnormal language(Koral) to improve accuracy and efficiency of filtering system. The method is based on syllabic than word and Smith-waterman algorithm. Through the experiment on filter keyword and e-mail extracted from mail server, we confirmed that Koral is recognized exactly according to similarity level. The required time and space costs are within the permitted limit.

Physician's Duty to Inform Treatment Risk: Function, Requirements and Sanctions (의사의 위험설명의무 - 법적 기능, 요건 및 위반에 대한 제재 -)

  • Lee, Dongjin
    • The Korean Society of Law and Medicine
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    • v.21 no.1
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    • pp.3-32
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    • 2020
  • Under the Korean case law, physicians are obliged to disclose or inform the risk associated with a specific treatment to their patients before they perform the treatment. If they fail to do this, they are liable to compensate pain and sufferings. If the patient can establish that he or she would not have consented at all to the treatment had he or she been informed, the physicians are liable to compensate all the loss incurred by the treatment. In this article, the author examines the legitimacy of this case law from the perspective of legal doctrine as well as its practical affect on the medical practice and the furtherance of self-determination of the patient. The fundamental findings are as follows: The case law that has physicians who failed to inform treatment risk compensate pain and sufferings for the infringement of the right of self-determination seems to be a disguised and reduced compensation of all the loss based on the possible malpractice, which cannot be justified in view of the general principles of tort liability. It is necessary to adhere to the requirements of causation and imputation between the failure to inform treatment risk and the specific patient's consent to the treatment. If this causation and imputation is established, all the loss should be compensated. Otherwise, there shall be no liability. The so-called hypothetical consent defence shall be regarded as a part of causation between the failure to inform and the consent. The suggested approach can preserve the essence of physician-patient relationship and fit for the very logic of informed consent better.

Analysis of Aggravated Perfusion in Myocardial SPECT after Coronary Artery Bypass Surgery (관동맥우회로술 후에 심근 SPECT에 나타난 관류의 악화 분석)

  • Lee, Won-Woo;Yoon, Seok-Nam;Kim, Ki-Bong;Chung, June-Key;Lee, Myung-Chul;Koh, Chang-Soon;Lee, Dong-Soo
    • The Korean Journal of Nuclear Medicine
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    • v.31 no.1
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    • pp.36-42
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    • 1997
  • Though myocardial perfusion was usually expected to improve after coronary artery bypass graft(CABG) surgery, some myocardial segments were aggravated after operation, as we compared perfusion changes on postoperative SPECT with preoperative ones. In this study, we evaluated perfusion changes after operation in rest and stress myocardial SPECT in 44 patients (M:F=25:19, age 57.1 $year{\pm}8.2$) who had CABG before and 3 months after operation. We tried to find out possible causes for perfusion aggravation with multivariate logistic regression analysis regarding whether bypass graft was artery or vein and which coronary artery territory was operated. Among 616 myocardial segments which were operated, 89(14.4%) aggravated after operation. In the univariate analysis, myocardial segments in the left circumflex arteries(LCx) aggravated more often(p<0.01) than others and segments having operative angioplasty did less often(p<0.01). Multivariate logistic regression revealed that LCx was risk factor for perfusion aggravation [odds ratio=2.54 (95% confidence interval : 1.53-4.22, p<0.01)]. However, this was not the case when we analysed in terms of arterial territories. Among 106 coronary arterial territories which were operated, 27(25.5%) aggravated. The territories having aggravated had similar characteristics regarding whether they received arterial or venous grafts, angioplasty and whether the operated territories were left anterior descending, right coronary or left circumflex arteries. In conclusion, myocardial segments in the left circumflex artery tended to aggravate more often after bypass surgery than the others. In short-term comparison of perfusion after surgery, we could not find any tendency that arterial or venous graft was associated with more frequency of the aggravation of perfusion after operation.

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The cooling effects of a paddy field area during 2006 summer (2006년 여름철 논에 의한 기온저감효과)

  • Kwon, Sung-Il;Kim, Jin-Soo;Park, Jong-Hwa;Oh, Kwang-Young;Song, Chul-Min
    • Proceedings of the Korea Water Resources Association Conference
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    • 2007.05a
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    • pp.628-632
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    • 2007
  • 본 연구에서는 2006년 여름철(2006년 7월 15일${\sim}$9월 30일) 동안 서로 다른 토지피복형태(논, 밭, 도시녹지대 및 도시주택지)에서의 기온변화 특성을 비교하여 논에 의한 기온저감 효과를 파악하였다. 혹서기 동안 총 3회(2006년 8월 3일, 11일, 15일)에 걸쳐 논으로부터의 거리에 따라 기온을 실측한 결과, 논으로부터 거리가 멀어짐에 따라 기온이 상승하였으며, 170m 지점에서의 기온은 논 지점보다 14시에는 $2.3^{\circ}C$, 22시에는 $1.8^{\circ}C$, 익일 06시에는 $1.3^{\circ}C$ 높게 나타났다. 혹서기 동안 논, 밭, 녹지대, 주택지에서의 열대야 완화효과를 비교해보면, 논이 열대야를 완화시키는 효과가 가장 큰 것으로 나타났다. $25^{\circ}C$이하로 낮아지는 평균시각은 논이 22.36시, 밭이 24.0시, 녹지대가 2.2시, 주택지가 2.3시로 나타났고, 이 시각으로부터의 평균 지속시간은 논이 7.7시간, 밭이 7.3시간, 녹지대가 4.3시간, 주택지가 1.0시간으로 나타났다. 또한 평균 일최저기온은 논이 $23.1^{\circ}C$로서 밭과는 동일하게 나타났으며, 녹지대보다 $0.9^{\circ}C$, 주택지보다 $3.0^{\circ}C$ 낮게 나타났다. 그러나 논과 밭에서의 기온저감효과는 큰 차이를 보이지 않았는데, 이는 기온저감효과가 식생피복상태에 의해 크게 좌우되기때문으로 생각된다. 본 연구에서는 논과 밭에 의한 기온저감효과의 메커니즘은 파악되지 않았으나, 이는 다양한 논지대 및 밭지대를 대상으로 열수지 특성을 분석함으로써 구명할 수 있을 것으로 생각된다.자로서는 제방 마루의 토지이용 및 식생구조, 하도의 식생유형, 하도주변 토지이용, 하안(bank) 형상 및 구조, 수종 및 구조, 하도 및 하안 특징 및 구조 등으로 선정, 검토하였다. 이상의 하천교란과 관계되는 지표를 선정하여 물리적, 생태적 조사 및 교란평가기법(안)을 개발, 제시하였다.EX>)를 보였으며, 그 중 3명에서는 혈역학적으로 큰 의미가 없는 잔여단락이 있었다. 결론: 급성 심근경색증 후 심실중격 결손은 수술위험도가 높은 질환이지만, 수술 전 대동맥내 풍선펌프를 삽입하고 조기에 심실중격 결손부의 infarct exclusion 술식과 함께 관상동맥우회술을 시행함으로써 만족할 만한 수술 및 중기 결과를 얻을 수 있었다.출물 투여로 저하되었으나 NC군보다는 높게 나타났다. 간 중 중성지질 함량은 참나물 에탄올 추출물 투여 용량에 따른 유의차가 없었으나, 총콜레스테롤 함량은 고용량 병합투여한 HC-PBH군만 유의하게 저하되었다. 혈청 및 간 중의 지질 함량 변화는 정상식이를 급여한 NC군과 NC-PB군 간에는 유의차가 없었다. 따라서 고콜레스테롤식이를 급여하면서 참나물 에탄올 추출물을 병합투여 시에만 지질대사 개선 효과가 있는 것으로 여겨지며, 고용량 병합투여 시 효능이 더 큰 것으로 나타났다. 고콜레스테롤식이로 인한 산화적 스트레스가 고콜레스테롤혈증을 유발하였으며, 이는 참나물 에탄올 추출물에 함유된 항산화물질을 포함한 여러 생리활성물질이 영향을 미친 것으로 사료된다. 이상의 실험 결과에서 참나물 에탄올 추출물은 고콜레스테롤식이로 증가된 총콜레스테롤, LDL-콜레스테롤 및 중성지질 함량은 감소시켰고, HDL-콜레스테롤과 인지질 함량은 증가시킴으로써 지방간 및 동맥경화의 예방과 치료에 효과적일 것으로 판단되어 진다./hr/g$, 섭취 7일중 $8.123\;{\mu}g/hr/

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Hydraulic Investigation of Pyokkolche Reservoir (벽골제의 수공학적 고찰)

  • Lee, Jang-U
    • Journal of Korea Water Resources Association
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    • v.31 no.4
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    • pp.397-406
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    • 1998
  • The Pyokkolche Reservoir was constructed as a major public project of the ancient agricultural society, 1600 years ago. From a hydraulic point of view, it is considered to have been carried out with a distinguished technology. It should be in particular noticed that for a consecutive banking the main stream was diverted and drained to the Yonpo stream and the dam with same sea levels on its top along the whole length was built in a nearly straight line in spite of the different sea levels between both ends on the bottom. These suggest that the carrying out artifice and surveying technigue of those days were considerably excellent. However, the insufficient plan and design at the time of the construction, the temporary management and the repeated repair works in the later ages caused the Pyokkolche to lose its function. The Changsaenggeo and Kyungjanggeo gate sites being the facilities for sluices composed of a simple span and a vertical lift hand-operated sing a pully. The advantage of the geographical characteristics at both ends of the main dam was scientifically taken to these sites which also functioned as a spillway against a flood. The gate site of Suyogeo must have been located in an entrance to Suwolri, the northern end of the Pyokkolche and Yutonggeo is presumed to have been located on the right of Sangsori, the southern end of the Pyokklche. Keywords : Pyokkolche Reservoir, construction technology, gate site location.

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A Study on the Effectiveness Analysis of Freeway Traffic Management Strategy Based on exTMS (exTMS기반의 고속도로 교통관리방안 효과분석에 관한 연구)

  • Sung, Ji-Na;So, Jae-Hyun;Oh, Young-Tae
    • The Journal of The Korea Institute of Intelligent Transport Systems
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    • v.8 no.5
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    • pp.38-47
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    • 2009
  • This paper aims to evaluate the freeway traffic management Strategy based on exTMS according to traffic situation of freeway. As freeway user's demands increase, we thus need future-oriented and optimized traffic management. So, through improving the existing system and introducing the advanced system, these systems evaluate for not only preparing the application in real world but also preliminary feasibility. To evaluate effects of the traffic management based on exTMS, in this study, shoulder LCS, advanced VMS(assumption in it is improving next-generation system which it can be offering diverse dynamic traffic information), Ramp-metering system are applicated in simulation. In addition, this study evaluates the effect when all proposed systems are applicated, and compare the individual effect of when independent system is applicated, through considering about traffic condition of V/C=0.5, V/C=0.8, V/C=1.2. The study results show that all assumed cases, the travel speed were improved according to the increasing V/C. Furthermore, the results of evaluated the individual system show that the shoulder LCS was found to be the largest effect, and the effect of VMS(detour rate is 11%) is larger than the other cases.

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An Experimental Study on Flow Characteristics Around Culvert According to Blocked Area (차단면적 변화에 따른 암거주변 흐름특성 실험연구)

  • Kim, Sung Joong;Yeo, Hong Koo;Kang, Jun Gu;Jung, Do Joon
    • Proceedings of the Korea Water Resources Association Conference
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    • 2016.05a
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    • pp.467-467
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    • 2016
  • 암거는 일반적으로 용수나 배수용의 수로가 도로, 철도, 제방 등의 아래에 매설 된 수로를 지칭한다. 이러한 암거는 산업발전으로 사회기반시설의 신설 및 확충, 재정비 등으로 많이 활용되고 있다. 최근 들어 기후로 인한 재해가 급증하면서 이러한 시설물에 대한 안정성 및 관리에 대한 관심이 높아지고 있는 것이 현실이다. 특히 소하천은 집수면적 및 유로연장이 짧고 하상경사가 급하기 때문에 홍수에 취약하다. 즉, 빨라진 유속으로 인해 구조물 주변의 세굴에 의한 유실, 토사유출로 인한 하상퇴적, 부유물로 인한 차단으로 인해 통수에 지장을 받아 피해가 발생하게 된다. 이러한 암거시설물 피해는 2차 피해로 이어질 수 있으며 사회기반시설 파괴로 도시기능이 마비되고 인근 주변지역에 침수로 인한 재산 및 인명피해까지 발생시킬 수 있는 피해 잠재능력을 보유하고 있다. 그러나 피해에 대한 예방대책은 유지관리를 통해 지속적으로 관리하는 것이 대부분의 지침 등에 소개된 내용들이다. 본 연구에서는 암거를 대상으로 암거의 폐색으로 인해 암거주변에서 변화되는 흐름특성을 축소모형을 통해 검토하고자 하였다. 암거 축소모형실험은 1.5m 폭을 갖는 직선수로에서 수행하였으며, 암거모형은 도로암거표준도(2008)를 참조하여 $3m{\times}3m$ 수로암거를 대상으로 1/10 축소모형을 제작하였다. 암거유입부 퇴적으로 인한 암거의 차단률(차단면적/암거단면적)은 차단이 발생하지 않는 0% 조건에서부터 10%, 20%, 30%, 40%, 50% 조건에 대해 실험을 수행하였다. 실험결과 차단에 따른 암거 상류단의 수위는 차단이 없는 암거의 경우에 비해 차단율이 높아질수록 암거유입부 수위는 20.4% ~ 82.7% 상승하는 것으로 나타났다. 암거의 차단률이 40% 이상일 경우 높아진 수위로 인해 암거통로의 윗상면부까지 다다르고 있으며 50%일 경우 암거를 통과하는 흐름이 자유수면흐름이 아닌 오리피스 흐름이 발생하는 것으로 나타났다. 암거유입부 차단으로 인한 암거주변의 최대유속은 암거 직하류부에서 주로 발생하여 암거 유출부에서의 최대유속은 차단율이 증가할수록 선형적으로 증가하는 것으로 나타났으며 암거 유출부에서의 유속은 차단전의 조건(0%) 대비 4.2% ~ 35.5% 까지 상승하는 것으로 나타났다. 이와 같은 결과를 토대로 고려하였을 때 대부분 산지부에서 설치되는 암거의 경우 유속이 불가피하게 증가하게 됨으로 유속에 따른 유속조절방안(차단 및 우회시설) 및 세굴대책을 세워야 할 것으로 판단된다.

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Analysis of Water Temperature Variations in Coastal Waters of the Korean Peninsula during Typhoon Movement (태풍 이동시 한반도 해역별 수온 변동 분석)

  • Juyeon Kim;Seokhyun Youn;Myunghee Park
    • Journal of the Korean Society of Marine Environment & Safety
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    • v.30 no.1
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    • pp.1-12
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    • 2024
  • In this study, we analyzed the water temperature variability in the sea area of the Korean Peninsula in August, before and after the typhoon inflow through Typhoon Soulik, the 19th in 2018 that turned right around the Korean Peninsula and passed through the East Sea, and Typhoon Bavi, the eighth in 2020 that advanced north and passed through the Yellow Sea. The data used in this study included the water temperature data recorded in the real-time information system for aquaculture environment provided by the National Institute of Fisheries Science, wind data near the water as recorded by the automatic weather system, and water temperature data provided by the NOAA/AVHRR satellite. According to the analysis, when typhoons with different movement paths passed through the Korean Peninsula, the water temperature in the East Sea repeatedly upwelled (northern winds) and downwelled (southern winds) depending on the wind speed and direction. In particular, when Typhoon Soulik passed through the East sea, the water temperature dropped sharply by around 10 ℃. When Typhoon Bavi passed through the center of the Yellow Sea, the water temperature rose in certain observed areas of the Yellow Sea and even in certain areas of the South Sea. Warmer water flowed into cold water regions owing to the movement of Typhoon Bavi, causing water temperature to rise. The water temperature appeared to have recovered to normal. By understanding the water temperature variability in the sea area of the Korean Peninsula caused by typhoons, this research is expected to minimize the negative effects of abnormal climate on aquaculture organisms and contribute to the formulation of damage response strategies for fisheries disasters in sea areas.